Tolerability of ORM-12741 and effects on episodic memory in patients with Alzheimer's disease

Introduction ORM-12741 is a novel selective antagonist of alpha-2C adrenoceptors. This trial evaluated the safety and efficacy of ORM-12741 in patients with Alzheimer's disease (AD). Methods A randomized, double-blind, placebo-controlled, exploratory phase 2a trial was conducted in 100 subjects with AD and neuropsychiatric symptoms. Participants were randomized to receive one of two flexible doses of ORM-12741 (30–60 mg or 100–200 mg) or placebo b.i.d. for 12 weeks in addition to standard therapy with cholinesterase inhibitors. Efficacy was assessed primarily with the Cognitive Drug Research (CDR) computerized assessment system and secondarily with the Neuropsychiatric Inventory (NPI). Results A statistically significant treatment effect was seen in one of the four primary CDR system end points, Quality of Episodic Memory (P = .030; not adjusted for multiple comparisons), favoring ORM-12741 over placebo. NPI caregiver distress scores also favored ORM-12741 (P = .034). ORM-12741 was well tolerated. Discussion This is the first clinical trial providing evidence on an acceptable safety profile for ORM-12741 in patients with AD and neuropsychiatric symptoms. In addition, the trial provided hints of potential therapeutic benefit, primarily on episodic memory, in this patient population

Application of the PET ligand [C-11]ORM-13070 to examine receptor occupancy by the alpha(2C)-adrenoceptor antagonist ORM-12741: translational validation of target engagement in rat and human brain

BackgroundAvailability of the α2C-adrenoceptor (α2C-AR) positron emission tomography (PET) tracer, [11C]ORM-13070, and the α2C-AR antagonist ORM-12741 allows probing of the roles of this G-protein coupled receptor subtype in brain function, both in healthy humans and in patients with various brain disorders. This translational study employed [11C]ORM-13070 autoradiography and PET to determine α2C-AR occupancy by ORM-12741 in rat and human brain, respectively.ResultsORM-12741 has high affinity (Ki: 0.08 nM) and potent antagonist activity (Kb: 0.04 nM) as well as selectivity (Ki estimates for the humanα2A-AR and α2B-AR were 8.3 nM and 0.8 nM, respectively) for the human α2C-AR subtype. [11C]ORM-13070 had highest uptake in the basal ganglia of rat and human brain. Pretreatment with ORM-12741 inhibited [11C]ORM-13070 binding in rat striatum in a time- and dose-dependent manner at 10 and 50 µg/kg (s.c.) with an EC50 estimate of 1.42 ng/mL in rat plasma, corresponding to protein-free drug concentration of 0.23 nM. In the living human brain, time- and dose-related α2C-AR occupancy was detected with EC50 estimates of 24 ng/mL and 31 ng/mL for the caudate nucleus and putamen, respectively, corresponding to protein-free concentrations in plasma of 0.07 nM and 0.1 nM. Modelling-based maximum α2C-AR occupancy estimates were 63% and 52% in the caudate nucleus and the putamen, respectively.ConclusionsORM-12741 is a selective α2C-AR antagonist which penetrates the rat and human brain to occupy α2C-ARs in a manner consistent with its receptor pharmacology.Trial registration number and date of registration: ClinicalTrial.cov NCT00829907. Registered 11 December 2008. https://clinicaltrials.gov/.</div

Quantitative determination of free and total dopamine in human plasma by LC-MS/MS:the importance of sample preparation

Background: Two methods have been developed and validated for the determination of free and total dopamine in human plasma. They are based on solid-phase extraction of the analyte from the matrix by covalent complexation with phenylboronic acid, followed by derivatization with ethylchloroformate. The derivative is quantified by reversed-phase liquid chromatography on a C18 column and positive electrospray ionization MS/MS. Results: The high selectivity obtained, in combination with the stable and relatively non-polar nature of the derivatized analyte, enables the reliable quantification of dopamine in the range 0.05 to 20 ng/ml in a 5 min run time, using only 100 mu l of sample. Total dopamine concentrations are determined (range 1 to 400 ng/ml) by including an acidic hydrolysis step, which converts the sulphate and glucuronide conjugates to free dopamine prior to extraction. The method was applied to quantify free and total dopamine levels in human plasma after dosing with the anti-Parkinson's drug combination L-dopa/carbidopa with and without entacapone. Conclusion: A sensitive and selective LC-MS/MS method has been developed and validated for the determination of free and total dopamine in human plasma. This article demonstrates how essential careful optimization of the sample preparation procedures was for developing a successful method